IBD treatment could also help prevent severe COVID-19 in patients

Receiving the COVID-19 vaccination strengthened one type of immune response to the SARS-CoV-2 virus in inflammatory bowel disease (IBD) patients, even though they were taking immunosuppressant medication, according to scientists at Cedars-Sinai in Los Angeles.

“We found that with COVID-19 vaccination most of the main immunosuppressive treatments for IBD preserved the T-cell response, with one notable exception: anti-tumor necrosis factor (anti-TNF) drug therapy,” says Dr. Gil Melmed, MD, principal investigator and director of Inflammatory Bowel Disease Clinical Research at Cedars-Sinai, in a statement. “This biologic treatment actually elevated T-cell activity in the vaccinated patients. We think this may help protect them from severe disease after breakthrough infection.”

Biologics, such as anti-TNF, are drugs that suppress inflammation, but can make IBD worse when it becomes chronic. T cells, a type of white blood cell, develop in the bone marrow and play a critical role in fending off viruses.

“Augmentation of the T-cell response by anti-TNF therapy may partially explain the recently reported association of biologics with reduced hospitalizations or death from COVID-19. The T-cell immune response is important for reducing severity of disease after COVID infection,” said Dalin Li, PhD, first author, and  IBD research scientist at Cedars-Sinai.

The researchers note that the findings indicate that there is the potential of developing clinical T-cell response tests that could be used to monitor new vaccine and booster outcomes.

“The benefit of anti-TNF on vaccine T-cell responses is a surprise. Efforts now should assess if it reduced hospitalizations after patients on this therapy had breakthrough infection,” adds Dr. Dermot McGovern, the director of Translational Research in the Inflammatory Bowel and Immunobiology Research Institute. “And we want to better understand the scientific mechanism, which could provide clues to enhance the T-cell side of the vaccine response.” 

The investigators have encouraging words for people receiving immunosuppressive therapies for inflammatory bowel disease.  “This should be important reassurance to vaccinated IBD patients who are receiving treatment; their therapies may be offering important protection from serious illness or hospitalization if they get a breakthrough infection,” says corresponding author Dr. Jonathan Braun. “It should also encourage them, and their doctors, to maintain their treatment during this phase of the pandemic and to keep up with their booster shots.” 

The findings of two studies on this topic have been published in the journals IBD, of the Crohn’s & Colitis Foundation, and Frontiers in Immunology.

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